Healthcare Provider Details

I. General information

NPI: 1053973388
Provider Name (Legal Business Name): GRACE TSAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 S COAST DR STE 260
COSTA MESA CA
92626-7719
US

IV. Provider business mailing address

940 S COAST DR STE 260
COSTA MESA CA
92626-7719
US

V. Phone/Fax

Practice location:
  • Phone: 714-907-2318
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number119380
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: